the thoughts of a surgeon in the notorious province of mpumalanga, south africa. comments on the private and state sector. but mostly my personal journey through surgery.

Wednesday, May 02, 2012

la mancha

the man was an enigma. those who knew him soon realised he was the only person in kalafong (hell) that cared anymore. somehow that terrible place hadn't eroded his soul to such an extent that he no longer gave a damn about his patients. yet to those who only had a fleeting acquaintance with him, he seemed course and even harsh. he didn't fit into kalafong (hell), yet he would not have fitted into any other place quite as well as he fitted into kalafong (hell). yes, he was an enigma.

my consultant in kalafong (hell), the enigma, had a certain way of bringing his point across (here and here). on the face of it it was never pretty but it was always funny in some twisted sort of way, despite that never being his intention. he also had a knack of going off on some wild tangent for seemingly no reason. what we may have thought was normal would more often than not set our own don quixote off on some wild quest chasing what seemed to us to be little more than windmills. but who were we to argue? he was after all the consultant.

so on that particular morning, when the house doctor showed the don the official consultation form from the internal department requesting us to drain an abscess on one of their patients there really was no way for him to know that this would cause the old man to fly into a frenzy and charge off towards the wards of the unsuspecting internal medicine department, his entire entourage, myself included, in tow. i was a very junior medical officer so i kept to the back and just observed.

"where are the doctors?" he bellowed at no one in particular as he stormed through the doors. "are you all deaf? i said where are your doctors? i want them here right now!" from behind a few curtains here and there the house doctors of that department peered, eyes wide, like frightened rabbits. still they froze and moved no closer.

"i said come here!" he shouted pointing directly at the closest one. "you! are you a doctor?" it seemed like a silly question. of course he was a doctor. but our master continued, "i said are you a doctor?"

"yes sir." wrong choice of words.

"don't call me sir!! do i look like i've been smacked on the shoulder by some foreign queen?"

"no, professor."

"don't call me professor!" his face went red with rage and despite it seeming impossible, the volume of his rantings increased. "i am not one of those academic professors in that ivory tower on the other side of town who operate by remote control from the comfort of their large chairs in their studies! i am a real surgeon!"

"sorry doctor."

"that's better." his voice dropped down back to jet plane decibels. "i asked you a question. are you a doctor?" the poor guy's lip quivered as he carefully and deliberately chose his words.

"yes doctor."

"what degree do you have?" we all cowered out of the direct line of sight of the man just in case he asked us the same seemingly easy question. at least we now knew not to call him sir or professor. but the poor internal house doctor had no such privilege.

"i have an mbchb, doctor." he almost whispered.

"yes you do. and do you know what that means?" before the confused victim could answer this next seemingly easy question our consultant blundered forth. "bring me a blade and show me where this patient is with the abscess.

a few moments later we were all standing around the patient wondering what was going to happen next. the house doctor was visibly shaking.

"i asked you a question?" continued our mentor, toying with the knife in his hand that the doctor had fetched for him "what does mbchb mean? or what does the chb part mean? the mb part is easy. that means you can give pills out. any old monkey can give pills out, but now i want you to tell me what the chb means"

"i'm not sure sir, i mean doctor!"

"if you call me sir again i will have you thrown up against the wall and i will bring a firing squad in here and have you summarily shot!" our consultant believed a firing squad covered a multitude of sins. "well let me tell you what it means. you see this sharp shiny thing in my hand? this is a blade. chb means you are trained to use one of these. it means you have a bachelors degree in surgery and it means you can lance an abscess. now watch me." he turned towards the unsuspecting patient. "you see now. this is the blade and this is the abscess. and this is the blade draining the abscess." with that he sunk the blade deep into the abscess. the patient winced, but, surprisingly made no other objection. i assumed he felt the threat of the firing squad may have been a general threat and that it was not limited to the poor house doctor. also once the thick stream of puss came out, there even seemed to be relief on the patient's face.

"there you go, mb and chb. now never consult us to drain an abscess again!" he turned and strode out. we had to follow. i was right at the back so i think i was the only one who heard the quiet and slightly bewildered voice of the house doctor as he said;

5 comments:

Bongi,I’ve been reading your blog for quite a while and I believe it should have received that “Medical Blog Awards” every year since you’re “on air”. If you allow it, as you are a very knowledgeable surgeon in South Africa, a bit off topic on your posts, I would like to know your point of view concerning Hamilton Naki’s presence during first heart transplant (was he there or not?). Different reliable sources seem to agree that he wasn’t there. Did he ever operate on humans?Thank you for your great writings

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the aim of this blog is to give insight into the mind of a particular surgeon, me. although every story is loosely based on fact, patients have been changed suitably to protect their identity. the opinions expressed are mine alone and are not meant to be considered medical advice or the opinion of any institution.